Evaluation of the Volatile Sulfur Compound Stability in Breath Samples for Halitosis Remote Diagnosis

This study assessed the feasibility of remote halitosis diagnosis by evaluating VSC stability over 7 days and their association with periodontal parameters.

One hundred adult patients attending a periodontal examination were included. Oral gas samples were collected using plastic syringes and analyzed by gas chromatography (OralChroma) at baseline (D0) and after 7 days of storage at room temperature (D7). Hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH), and dimethyl sulfide ((CH₃)₂S) were quantified. Periodontal parameters were recorded. Correlations and agreement analyses were performed.

At D0, 64% and 31% of patients were classified as having halitosis using thresholds of > 120 ppb and > 300 ppb, respectively. Mean VSC concentrations were 10.2 (33.1) ppb for H₂S, 208.3 (443.2) ppb for CH₃SH, and 79 (166) ppb for (CH₃)₂S, and increased after 7 days of storage for all compounds except H₂S. Only (CH₃)₂S showed a significant correlation between D0 and D7 measurements. Agreement between halitosis diagnoses at D0 and D7 was poor for both thresholds (Cohen's kappa < 0.2). Associations between VSC levels and periodontal parameters were weak.

Delayed analysis of oral gas samples significantly altered VSC measurements limiting their reliability for remote halitosis diagnosis. Periodontal parameters were not strongly associated with VSC levels.